The Outcomes and Costs of an Interagency Partnership to Serve Maltreated Children in State Custody

Swenson, Cynthia Cupit; Randall, Jeff; Henggeler, Scott W.; Ward, David M.

doi:10.1207/s15326918cs0304_1

Cited by 10 publications

(27 citation statements)

References 11 publications

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“…Nine studies [183][184][185][186][187][188][189][190][191][192][193][194][195][196][197][198] examined the effects of these models of care. Five studies [183][184][185][186][187][188]190,191,194,198 measured psychological distress, five studies 189,192,194,197,198 looked at behavioural outcomes, four studies 190,191,194,195,197 explored social functioning, three studies 190,191,197 measured cognitive performance, two studies 194,198 examined addiction behaviour, one study 190,191 examined resilience and two studies 190,191 looked at placement stability.…”

Section: Intensive Service Modelsmentioning

confidence: 99%

“…In total we identified six studies 198,[612][613][614][615][616] assessing the cost-effectiveness of relevant psychosocial interventions for maltreated children: five studies 198,[613][614][615][616] were carried out using data from a trial and one study 612 used a decision-analytic model. Of the five trial-based studies, 198,[613][614][615][616] data were from four RCTs 198,[613][614][615] and one cohort study.…”

Section: Included Studiesmentioning

confidence: 99%

“…Of the five trial-based studies, 198,[613][614][615][616] data were from four RCTs 198,[613][614][615] and one cohort study. 616 All six studies 198,[612][613][614][615][616] were published in English and were carried out in the USA 198,615,616 (n = 3), the UK 613,614 (n = 2) and Australia 612 (n = 1). The basic characteristics of the six included studies 198,[612][613][614][615][616] are presented in Table 8, and more detailed descriptions are presented in Chapter 4.…”

Section: Included Studiesmentioning

confidence: 99%

“…Age In the RCT-based evaluations, one study 615 included preschool children in foster care aged between 3 and 5 years, one study 615 included children who had been adopted between the ages of 3 and 8 years, 613 and two studies 198,614 included a broader age range: the first study 198 involved maltreated children between 1 and 16 years and the second study 614 used a sexual abuse sample of children aged between 6 and 14 years. In the cohort study, 616 no age range was reported, just the mean of the groups, which was 8.9 years in one group and 5.4 years in the other.…”

Section: Participantsmentioning

confidence: 99%

“…Gender Four 198,613,615,616 of the five trial-based studies included both girls and boys, with an average of 49% being girls (range 43-54%). The exception focused on an intervention that was specifically for girls who had been victims of sexual abuse.…”

Section: Participantsmentioning

confidence: 99%

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The effectiveness, acceptability and cost-effectiveness of psychosocial interventions for maltreated children and adolescents: an evidence synthesis

Macdonald

Livingstone

Hanratty

et al. 2016

Health Technol Assess

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BackgroundChild maltreatment is a substantial social problem that affects large numbers of children and young people in the UK, resulting in a range of significant short- and long-term psychosocial problems.ObjectivesTo synthesise evidence of the effectiveness, cost-effectiveness and acceptability of interventions addressing the adverse consequences of child maltreatment.Study designFor effectiveness, we included any controlled study. Other study designs were considered for economic decision modelling. For acceptability, we included any study that asked participants for their views.ParticipantsChildren and young people up to 24 years 11 months, who had experienced maltreatment before the age of 17 years 11 months.InterventionsAny psychosocial intervention provided in any setting aiming to address the consequences of maltreatment.Main outcome measuresPsychological distress [particularly post-traumatic stress disorder (PTSD), depression and anxiety, and self-harm], behaviour, social functioning, quality of life and acceptability.MethodsYoung Persons and Professional Advisory Groups guided the project, which was conducted in accordance with Cochrane Collaboration and NHS Centre for Reviews and Dissemination guidance. Departures from the published protocol were recorded and explained. Meta-analyses and cost-effectiveness analyses of available data were undertaken where possible.ResultsWe identified 198 effectiveness studies (including 62 randomised trials); six economic evaluations (five using trial data and one decision-analytic model); and 73 studies investigating treatment acceptability. Pooled data on cognitive–behavioural therapy (CBT) for sexual abuse suggested post-treatment reductions in PTSD [standardised mean difference (SMD) –0.44 (95% CI –4.43 to –1.53)], depression [mean difference –2.83 (95% CI –4.53 to –1.13)] and anxiety [SMD –0.23 (95% CI –0.03 to –0.42)]. No differences were observed for post-treatment sexualised behaviour, externalising behaviour, behaviour management skills of parents, or parental support to the child. Findings from attachment-focused interventions suggested improvements in secure attachment [odds ratio 0.14 (95% CI 0.03 to 0.70)] and reductions in disorganised behaviour [SMD 0.23 (95% CI 0.13 to 0.42)], but no differences in avoidant attachment or externalising behaviour. Few studies addressed the role of caregivers, or the impact of the therapist–child relationship. Economic evaluations suffered methodological limitations and provided conflicting results. As a result, decision-analytic modelling was not possible, but cost-effectiveness analysis using effectiveness data from meta-analyses was undertaken for the most promising intervention: CBT for sexual abuse. Analyses of the cost-effectiveness of CBT were limited by the lack of cost data beyond the cost of CBT itself.ConclusionsIt is not possible to draw firm conclusions about which interventions are effective for children with different maltreatment profiles, which are of no benefit or are harmful, and which factors encourage people to seek therapy, accept the offer of therapy and actively engage with therapy. Little is known about the cost-effectiveness of alternative interventions.LimitationsStudies were largely conducted outside the UK. The heterogeneity of outcomes and measures seriously impacted on the ability to conduct meta-analyses.Future workStudies are needed that assess the effectiveness of interventions within a UK context, which address the wider effects of maltreatment, as well as specific clinical outcomes.Study registrationThis study is registered as PROSPERO CRD42013003889.FundingThe National Institute for Health Research Health Technology Assessment programme.

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Section: Intensive Service Modelsmentioning

confidence: 99%

Section: Included Studiesmentioning

confidence: 99%

Section: Included Studiesmentioning

confidence: 99%

Section: Participantsmentioning

confidence: 99%

Section: Participantsmentioning

confidence: 99%

See 3 more Smart Citations

The effectiveness, acceptability and cost-effectiveness of psychosocial interventions for maltreated children and adolescents: an evidence synthesis

Macdonald

Livingstone

Hanratty

et al. 2016

Health Technol Assess

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Youths living away from families in the US mental health system

Pottick

Warner

Yoder

2005

The Journal of Behavioral Health Services & Research

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This study examines the clinical characteristics of youths who lived away from families at the time of admission to specialty mental health services, and investigates the association between type of nonfamily living situation and admission to residential versus outpatient programs. Of 3995 youths sampled from 1598 mental health programs in the United States, 14% lived away from their own families, either in foster care, group care settings, or correctional settings, or were emancipated. As a group, youths living away from families were more seriously emotionally disturbed and more likely to receive treatment in residential care programs. Youths who lived in foster care were more likely to be admitted to outpatient programs, while youths who lived in group care settings or correctional settings were more likely to be admitted to residential care programs, controlling on demographic and clinical characteristics. Targeting resources to enhance the availability and therapeutic capacity of foster care may facilitate community living, and decrease time spent in institutional settings.

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The Potential of Pay-for-Success as a Financing Strategy for Evidence-Based Practices: An Illustration with Multisystemic Therapy

Dopp

Perrine

Iovan

et al. 2019

Adm Policy Ment Health

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There is a critical need to identify strategies for financing the implementation of evidence-based practices. We illustrate the potential of pay-for-success financing (PFS)-a strategy in which private investors fund implementation and receive a return on investment from a government payer-using multisystemic therapy as an example. We argue that standard multisystemic therapy (for serious juvenile offenders) and several of its adaptations (for other complex behavioral problems in youth) would be good candidates for PFS in the right contexts. Despite some challenges for policymakers and administrators, PFS has significant potential as a financing strategy for evidence-based practices.

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The Outcomes and Costs of an Interagency Partnership to Serve Maltreated Children in State Custody

Cited by 10 publications

References 11 publications

The effectiveness, acceptability and cost-effectiveness of psychosocial interventions for maltreated children and adolescents: an evidence synthesis

The effectiveness, acceptability and cost-effectiveness of psychosocial interventions for maltreated children and adolescents: an evidence synthesis

Youths living away from families in the US mental health system

The Potential of Pay-for-Success as a Financing Strategy for Evidence-Based Practices: An Illustration with Multisystemic Therapy

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